Resilient Health Care

This book promotes an understanding of the purposeful muddling that health care workers rely on to be better able to function and operate in the multitude of complex ecosystems we call "health care." The book argues the case for the importance of recognising and understanding muddling behaviours, practices and activities in order to create resilient care. The book demonstrates how resilient health care principles can enable managers as well as those on the frontlines to work more effectively towards interdisciplinary care by gaining a deeper understanding of real-world practices that manifest in everyday clinical settings. This is done by presenting a set of case studies, theoretical chapters and applications that relate experiences, bring forth ideas and illustrate practical solutions. Primarily aimed at people who are directly involved in the running and improvement of health care systems, it provides practical guidance. It is also of direct interest to health care professionals in clinical and managerial positions as well as researchers. Jeffrey Braithwaite is Founding Director of the Australian Institute of Health Innovation, Professor of Health Systems Research and Director of the Centre for Healthcare Resilience and Implementation Science, Macquarie University (Australia). His research examines the changing nature of complex health systems and he has received over 50 different national and international awards for his teaching and research. Erik Hollnagel is Senior Professor of Patient Safety at Jönköping University (Sweden). He is a highly regarded international expert with significant contributions to a variety of fields ranging from nuclear power generation, aerospace and aviation to industry, transportation and, most notably, health care. Garthe Hunte is a Clinical Professor and Emergency Physician holding multiple academic and clinical leadership appointments across Canada. His research programme centres around how safety is created in complex socio-technical systems, and in the application of resilience engineering in health care.

Jeffrey Braithwaite, BA, MIR (Hons), MBA, DipLR, PhD, FIML, FACHSM, FFPHRCP (UK), FAcSS (UK), Hon FRACMA, FAHMS is Founding Director, Australian Institute of Health Innovation; Director, Centre for Healthcare Resilience and Implementation Science; and Professor of Health Systems Research, Faculty of Medicine and Health Sciences, Macquarie University, Australia. His research examines the changing nature of complex health systems, attracting funding of more than AU$145 million (EUR89 million, £82 million). He has contributed over 620 peer reviewed publications including 14 previous books, and presented at international and national conferences on more than 1,000 occasions, including over 100 keynote addresses. His research appears in journals such as Journal of the American Medical Association, BMC Medicine, The British Medical Journal, The Lancet, Social Science & Medicine, BMJ Quality & Safety and International Journal for Quality in Health Care. He has received 48 different national and international awards for his teaching and research. Further details are available on the AIHI website: http://aihi.mq.edu.au/people/professor-jeffrey-braithwaite and his Wikipedia entry at https://en.wikipedia.org/wiki/Jeffrey_Braithwaite. Erik Hollnagel, MSc, PhD, is Senior Professor of patient safety at Jönköping University (Sweden), Visiting Professorial Fellow at the Centre for Healthcare Resilience and Implementation Science, Macquarie University, Australia, and Professor Emeritus at the Department of Computer Science, University of Linköping, Sweden. He has through his career worked at universities, research centres and industries in several countries and with problems from many domains including nuclear power generation, aerospace and aviation, software engineering, land-based traffic and health care. His professional interests include industrial safety, resilience engineering, patient safety, accident investigation and modelling large-scale sociotechnical systems. He has published widely and is the author or editor of 24 books, including five books on resilience engineering, as well as a large number of papers and book chapters. The latest titles are Safety-I and Safety-II in Practice and Working Across Boundaries. Garth Hunte, MD, PhD, FCFP is a Clinical Professor and Emergency Physician at Providence Health Care/UBC, a Virtual Physician, HealthLinkBC Emergency iDoctor-in-assistance, the Innovation Lead for Patient Safety and Resilient System Performance in Emergency Care in the Department of Emergency Medicine, University of British Columbia, a scientist at the Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, a member of the Centre for Health Education Scholarship, and a member of the Physician Advisory Committee, Exceptional Quality, Safety and Value, Providence Health Care, in Vancouver, Canada. His research program centers around how safety is created in complex socio-technical systems, and in the application of resilience engineering in healthcare. He is actively involved in the Resilience Engineering Association and the Resilient Health Care Network, and organized/hosted the 6th Resilient Health Care Meeting in Vancouver in 2017.

1. The Journey to Here. 2. On Muddling Through (its definitions, scope, and ways to work in a world of muddle to enable resilient performance in systems, organisations and services). Section 1: Understanding Purpose and Muddling Through. Section 2: Theorising About Purposeful Muddling. Section 3: Case Studies of Muddling and Resilient Health Care. 3. Working with Muddling in a Purposeful Way.

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